Metallic prosthesis: technique to avoid increase in CT radiation dose with automatic tube current modulation in a phantom and patients.

The institutional review board approved this Health Insurance Portability and Accountability Act-compliant study protocol, with waiver of informed consent. The purpose of the study was to retrospectively evaluate the combined automatic tube current modulation technique in patients with orthopedic metallic prostheses. Five hundred abdominal-pelvic computed tomographic (CT) studies performed with combined modulation technique were reviewed to identify nine patients with metallic prostheses (mean age, 66 years; range, 35-86 years; male-female ratio, 5:4). On the basis of age and transverse abdominal images, these patients were matched with nine others with no metallic prostheses (mean age, 56 years; range, 36-72 years; male-female ratio, 4:5) who were control patients. Images were graded for extent and severity of streak artifacts (grade 1, streak artifact present but not substantially compromising evaluation of adjacent structures; grade 2, streak artifact present and slightly compromising evaluation of adjacent structures; and grade 3, streak artifact present and severely compromising evaluation of adjacent structures). Student t test was performed for statistical analysis. There was no difference in mean effective tube current-time product between study and control patients (P > .49). With automatic tube current modulation, an increase in CT dose caused by metallic prostheses can be successfully avoided.